CT Stroke Aging(From Diagnostic Neuroradiology by Osborn)
Hyperacute (<12h)
Normal (50-60%)
Hyperdense artery (25-50%)
Obscuration of lentiform nuclei
Acute (12-24h)
Low density basal ganglia
Loss of gray-white interfaces (insular ribbon sign, obscuration of cortex-medullary white matter border)
Sulcal effacement
1-3days
Increasing mass effect
Wedge-shaped low density area that involves both gray and white matter
Hemorrhagic transformation may occur (most often basal ganglia and cortex)
4-7 days
Gyral enhancement
Mass effect, edema persist
1-8 weeks
Contrast enhancement perists
Mass effect resolves
Transient calcification can occur (pediatric strokes)
Months-years
Encephalomalacic change, volume loss
Calcification rare
Hyperacute (<12h)
Normal (50-60%)
Hyperdense artery (25-50%)
Obscuration of lentiform nuclei
Acute (12-24h)
Low density basal ganglia
Loss of gray-white interfaces (insular ribbon sign, obscuration of cortex-medullary white matter border)
Sulcal effacement
1-3days
Increasing mass effect
Wedge-shaped low density area that involves both gray and white matter
Hemorrhagic transformation may occur (most often basal ganglia and cortex)
4-7 days
Gyral enhancement
Mass effect, edema persist
1-8 weeks
Contrast enhancement perists
Mass effect resolves
Transient calcification can occur (pediatric strokes)
Months-years
Encephalomalacic change, volume loss
Calcification rare